Long-term effects of balloon angioplasty on left ventricular hypertrophy in adolescent and adult patients with native coarctation of the aorta. Up to 18 years follow-up results
| Autor: | Shahid Malik, Ahmad Al Omrani, Nathem Akhras, Mahmoud Awad, Mohamed Shoukri, Mohamed Fawzy, Walid Hassan |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Coarctation of the aorta Balloon Left ventricular hypertrophy Aortic Coarctation Muscle hypertrophy Angioplasty Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Retrospective Studies Cardiac catheterization business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Confidence interval Treatment Outcome Echocardiography Cardiology Female Hypertrophy Left Ventricular Cardiology and Cardiovascular Medicine business Angioplasty Balloon Follow-Up Studies |
| Zdroj: | Catheterization and Cardiovascular Interventions. 70:881-886 |
| ISSN: | 1522-726X 1522-1946 |
| Popis: | Little is known regarding the long-term follow-up results of balloon angioplasty (BA) for patients with native aortic coarctation (AC) on left ventricular hypertrophy (LVH) regression.The purpose of this study was to define the long-term effect of BA of AC on LVH in adolescent and adult patients.Follow-up data of 53 patients (36 male) mean age 24 +/- 9 years undergoing BA for discrete AC at median interval of 11.8 years (range 4-18 years) including cardiac catheterization, magnetic resonance imaging, and Echocardiography form the basis of this study. Patients were divided into two groups at 1 year after BA based on absence (group A) or presence (group B) of persistent hypertension and need for medication.Forty-nine patients had baseline LVH, BA produced an immediate reduction in peak AC gradient from 66 +/- 23 mm Hg (95% confidence interval [CI]: 59.5-72.7) to 10.8 +/- 7 mm Hg (95% CI: 8.8-12.5) (P0.0001). Follow-up catheterization 12 months later revealed a residual gradient of 6.2 +/- 6 mm Hg (95% CI: 4.4-7.9) (P0.001). The blood pressure had normalized without medication in 38 of the 49 patients (165 +/- 17 to 115 +/- 10 mm Hg). Left ventricular mass index (LVMI) decreased significantly (20% decrease LVMI from baseline) in 48 patients (98%) at median interval 1.4 years (range 0.5-3 years) post BA, group A (38 patients) LVMI decreased from 132 +/- 30.7 g/m(2) (95% CI: 122-141.9) to 86 +/- 19.9 g/m(2) (95% CI: 79.5-92.5) (P0.0001). Similarly, in 10 patients (group B) the LVMI decreased from 157 +/- 38.7 g/m(2) (95% CI: 127-185) to 102 +/- 29 g/m(2) (95% CI: 105-151) (P0.0001) at follow-up. Mild (20% decrease in LVMI) regressions were noted in one patient from group B. There was no progression to LVH in the four patients who had normal baseline LVMI.(1) Long-term results of BA for discrete AC are excellent and should be considered as first option for treatment of this disease; (2) Regression of LVH (or =20% reduction in LVMI) occurred in 98% of patients after BA. |
| Databáze: | OpenAIRE |
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